Mixed Invasive Fungal Pneumonia Caused by Aspergillus , Candida , Mucor in an Immunocompromised Host

ABSTRACT

Invasive fungal pneumonia (IFP) is a life‐threatening complication in immunocompromised patients, particularly those with hematologic malignancies. Mixed IFP are uncommon, given its substantial diagnostic and therapeutic challenges. We report a case of rapidly progressive mixed IFP caused by Aspergillus , Candida and Mucor species in a 60‐year‐old man with diffuse large B‐cell lymphoma following chemotherapy. Despite early empirical broad‐spectrum antibiotics and prompt initiation of antifungal therapy guided by serum galactomannan positivity and radiologic progression, the patient's clinical condition deteriorated. Bronchoscopy revealed extensive necrotic endobronchial lesions, and histopathologic examination confirmed simultaneous infection with three fungal pathogens. Although intensive treatment with an antifungal agent and mechanical ventilation were provided, the patient died of refractory respiratory failure within 1 week of hospitalization. This case highlights that clinicians should actively consider mixed fungal infection as a potential aetiology of IFP in immunocompromised patients, rather than assuming a single‐pathogen process.